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General NPI Number Information
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NPI Number | 1982634911
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Entity Type | Organization
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Legal Business Name | ACADIANA DIAGNOSTIC IMAGING LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2309 E MAIN ST STE 100
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City | NEW IBERIA
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State | LA
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Zip | 70560-4046
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Country | US
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Telephone | 337-367-3910
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Fax | 337-367-0131
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Provider Business Mailing Address
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Address Line | PO BOX 3711
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City | LAKE CHARLES
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State | LA
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Zip | 70602-3711
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Country | US
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Telephone | 337-367-3910
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Fax | 337-367-0131
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BOYD D SNELLGROVE
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Credential | M.D.
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Telephone | 337-367-3910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State | LA
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